10 Key Findings from our 2023 Annual Report on Medical Staff Credentialing

The Annual Report on Medical Staff Credentialing is a time to reflect on the past year, how the industry has grown, progress towards achieving goals, and trends to watch for the future. The report produced by VerityStream™ by HealthStream™ has become an industry standard with the 2023 survey receiving the most responses (1,181) since its inception seven years ago.

The past year has seen a wind-down of the COVID-19 pandemic where lessons learned throughout helped to reduce paper, reimagine processes, advance technology and evaluate resource usage. These lessons can be seen throughout the report in the desire to increase provider satisfaction with credentialing processes, increase process automation, take advantage of technology tools, and boost ongoing monitoring and competency assessment programs.

This year's report is organized around 10 key findings related to credentialing and privileging. They are as follows:

Finding 1: Similar to previous years’ survey results, the majority (94.1%) of medical services professionals reported some level of satisfaction with the quality of the medical staff credentialing and privileging processes provided by their organization.

Finding 2: Process Improvement and Provider Data Management initiatives continued to be rated as the most important initiatives at their organizations.

Finding 3: Across the following four initiatives, Process Improvement, Provider Data Management, Centralization and Enterprise Standardization, and Service Expansion, survey participants reported the biggest impediments at their organization were internal resource constraints, competing priorities, and vendor/software limitations.

Finding 4: Within Process Improvement, Provider Data Management, Centralization and Enterprise Standardization, and Service Expansion, 27 activities were evaluated. For 14 of the 27 activities, more than 50 percent of respondents reported full or partial implementation at their organization which was a slight decrease from 2022 (17 of 27).

    Process Improvement

• Implementing electronic, paperless credentialing files for your providers
• Implementing an automated, paperless process for online provider applications
• Reducing initial and re-credentialing time frames through automation
• Implementing an automated, paperless process for primary source verifications
• Implementing an automated, paperless process for delineation and tracking of privileges
• Implementing a paperless process for your committee reviews and decisions
• Automating the peer review process
• Automating OPPE performance profiles and workflow

    Provider Data Management

• Implementing a single, master provider database for your enterprise that is the single source of truth for provider data
• Managing, updating, and validating data on referring providers
• Integrating your provider data with downstream applications including EMR, laboratory, pharmacy, billing, payer, and marketing databases
• Creating new data roles within your organization including Director of Provider Analytics, Database Administrators, Data Scientists, or others
• Adding data to your provider database including CAHPS data, social media information, and information that reflects patient input

    Centralization & Standardization

• Implementing a single online application for your entire organization
• Standardizing privileging criteria, forms, and core privileges across the enterprise
• Updating medical staff by-laws to reflect enterprise processes and standards
• Integrating your Provider Enrollment activities within your MSO(s) or CVO
• Implementing a centralized or regional CVO separate from your MSO
• Implementing a centralized or regional MSO to support multiple facilities

    Service Expansion

• Developing an integrated provider onboarding process across multiple departments
• Managing the Provider Enrollment process for your providers by requesting their participation in a health insurance network as a Participating Provider
• Handling Delegated Credentialing services
• Managing the Provider Directory for your "Find the Doctor" functionality on your website
• Handling network management and managed care responsibilities for the payer and ACO entities within your organization
• Providing and tracking Continuing Medical Education (CMEs) for your providers
• Managing or coordinating graduate medical education programs
• Non-provider credentialing services for employees including nurses and other staff

Finding 5: Six out of eight activities within the Process Improvement initiative were reported either partially or fully successfully implemented by more than 50 percent of surveyed participants.

Finding 6: The top activity to be fully and successfully implemented within the Provider Data Management initiative continued to be the implementation of a single, master provider database, for the sixth year in a row.

Finding 7: Three out of six Centralization and Enterprise Standardization activities were reported either partially or fully successfully implemented by more than 50 percent of surveyed participants.

Finding 8: The Service Expansion initiative was the only one that contained activities with significant increases from the previous years. Also, in an increase from 2022, four of the eight Service Expansion initiatives were fully or partially implemented by more than 50 percent of respondents.

Finding 9: Those who reported the transition from fee-for-service to value-based and/or bundled reimbursement had a significant impact on their organization continued to decrease (down to 11.5 percent) - again with the lowest reported numbers since this data collection began.

Finding 10: The majority of respondents (85.5%) continued to report their providers had some level of satisfaction with the services related to the credentialing and privileging processes provided by their organization.

For a deeper dive into each finding, we encourage you to download the 2023 Annual Report on Medical Staff Credentialing.

And, as always, it is with pride that we present this Medical Staff Credentialing Report to the healthcare industry. There are many people involved in launching the survey, analyzing the results, and getting the report into a format that presents the results in a clear and understandable manner. We thank everyone who responded to the survey and HealthStream for providing the resources necessary to package our learnings into this report. We honor each one of the MSPs who work in this industry ensuring the safety of patients, and it is our hope healthcare organizations will use this information to determine where they will focus their improvement efforts.